Pandey Deb P, Ghimire Amod, Shrestha Bhola R
South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka; School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia; Department of Veterinary Microbiology and Parasitology, Agriculture and Forest University, Rampur, Chitwan, Nepal.
Patan Academy of Health Sciences, Kathmandu, Nepal.
Wilderness Environ Med. 2019 Mar;30(1):79-85. doi: 10.1016/j.wem.2018.11.001. Epub 2019 Feb 6.
This case report documents envenomation by an arboreal white-lipped green pit viper (Trimeresurus albolabris), a species found in South and Southeast Asia that causes the majority of venomous snakebites among Southeast Asian pit vipers. Clinical features vary from asymptomatic to serious coagulopathy that may progress into life-threatening or fatal hemorrhage. The proven life-threatening cases described in published literature, however, are sparse. Practically, no specific antivenom targeted to pit viper bites is available in Nepal. We report a case (managed with several non-evidence-based interventions) of noticeable coagulopathic envenomation due to confirmed T albolabris bite in Nepal. This is the first known reported case of such a bite in Nepal. This case highlights the urgent need to improve diagnosis, monitoring, and supportive care for bite victims and to study the effectiveness of Thai pit viper antivenoms for the treatment of T albolabris envenomations.
本病例报告记录了一例被树栖白唇竹叶青（Trimeresurus albolabris）咬伤中毒的病例。白唇竹叶青是一种在南亚和东南亚发现的蛇类，在东南亚蝮蛇导致的大多数毒蛇咬伤事件中，它是罪魁祸首。临床症状从无症状到严重的凝血病不等，凝血病可能会发展为危及生命或致命的出血。然而，已发表文献中描述的经证实的危及生命的病例很少。实际上，尼泊尔没有专门针对蝮蛇咬伤的抗蛇毒血清。我们报告了一例在尼泊尔因确诊被白唇竹叶青咬伤而出现明显凝血病中毒的病例（采用了几种非循证干预措施进行治疗）。这是尼泊尔首例已知的此类咬伤报告病例。该病例凸显了迫切需要改善对咬伤受害者的诊断、监测和支持性护理，并研究泰国蝮蛇抗蛇毒血清治疗白唇竹叶青咬伤中毒的有效性。
